Life and Health News

February 2019

Welcome to our latest newsletter!  As a thought leader in the Insurance Industry for over 50 years we are always excited to share the latest sampling of insurance compliance related bulletins, regulations and legislative activity. Please feel free to share this newsletter with others that may be interested.  Contact Us with any questions on the items in this newsletter or with any other compliance related matter we can assist you with. Enjoy!


ACTUARIAL

New Hampshire amended its regulation regarding actuarial opinion and memorandum and added a new section.  The new section gives the Department the ability to waive any requirements of this part if the waiver does not contradict its objective or intent, and the application of the requirements would cause confusion, be misleading to consumers, be inapplicable under the relevant circumstances, or any of the other specified circumstances.  The waiver can be granted at the Department's initiative or upon an insurer's request.  Effective April 1, 2019.     2401.01 - 2401.0


ADVERTISING / SALES & MARKETING

Vermont issued an emergency regulation regarding advertising and marketing for self-insured multiple employer welfare arrangements and association health plans.     Emergency Regulation 2018-02-E s 13


AGENT / PRODUCER LICENSING AND APPOINTMENT

Michigan issued a bulletin containing new requirements applicable to resident and non-resident agency and individual insurance producer applicants for the variable annuities line of authority.     Bulletin 2018-24-INS

Utah adopted a new regulation that creates a process allowing prospective licensees with certain felony convictions to petition the Commissioner for written consent to participate in business of insurance.     Rule R590-278

Vermont issued an emergency regulation requiring insurance agents and brokers to provide specified notifications to the DOI and to the employer or resident regarding the sale of a health benefit plan on behalf of multiple employer welfare arrangements and association health plans.     Emergency Regulation 2018-02-E s 17


ANNUITIES / ANNUITY CONTRACTS

Florida has amended rule 69O-125.003, Unfair Discrimination Because of Travel Plans, to remove a requirement for insurers to report the refusal or limitation of annuity contracts based on the applicant’s past or future lawful foreign travel.     FAC Rule 69O-125.003


ANNUITY DISCLOSURES

Rhode Island amended its regulation concerning annuity disclosures.     230-RICR-20-25-6


CAPTIVES

Texas amended regulations regarding captive insurance.     28 TAC s 6.1, 6.2, 6.202, 6.203, 6.302, 6.303, 6.401, 6.409, 6.411


COMPLAINTS

Maryland issued a bulletin announcing that it has started using a new online complaint tracking system, the Enterprise Complaint Tracking System (ECTS). This allows two-way written communication and document transmission between the Administration and its licensees beginning 2/1/19.     Bulletin 18-25

Puerto Rico adopted a new law regarding the notice form required for bringing civil action for breaches and violations of certain provisions of the Insurance Code.     Ruling CN-2019-246-D


CONFIDENTIALITY / PRIVACY

New Jersey issued a bulletin notifying insurers that the Department did not adopt any new annual notice requirements based upon NAIC Model #672, and the existing Information Practices Act that has applied since 1985 continues to apply to insurers operating in New Jersey.     BULLETIN NO. 18-16


CORPORATE GOVERNANCE

Michigan enacted legislation concerning the corporate governance annual disclosure (CGAD).  The implementation date is January 1, 2020 and companies need to file the first report before June 1, 2020 and by each June 1 thereafter.     HB 6520; 500.1751; 500.1755; 500.1757; 500.1759; 500.1761; 500.1763; 500.1765; 500.1767; 500.3032


CYBERSECURITY

Michigan enacted legislation to establish the exclusive standards applicable to licensees for data security, the investigation of a cybersecurity event, and notification to the director.     HB 6491


DEPENDENT COVERAGE

Ohio amended its regulation regarding the definition of eligible dependent for health care coverage as it relates to disability benefits.     Rule 145-4-09


DISASTER PREPAREDNESS

Maryland issued a bulletin requesting all insurers update contact information for use in the event of a disaster or catastrophic event by April 15, 2019.  The information can be submitted electronically.     Bulletin 19-02


FILING REQUIREMENTS / PROCEDURES

Louisiana has amended Policy Form Filing requirements to provide uniform procedures regarding the withdrawal of a previously approved filing and the right of the insurer to request a hearing on a withdrawn or unapproved filing. The DOI has removed the requirement that companies submit their request for a hearing to the DOI and the Division of Administrative Law. The amendments are effective 01/01/19.     LAC 37:XIII.Chapter 101

Maryland issued a bulletin to provide guidance on filing requirements for individual and small employer form and rate filings for plans beginning on or after 01/01/20.     Bulletin 19-01

Oregon issued a bulletin to clarify requirements and procedures regarding the use of corporate and assumed business names by insurers.     Bulletin 2019-1


FRAUD / ANTI-FRAUD

Michigan has amended their Identity Theft Protection Act to state that, effective 01/20/20, an entity that is regulated under the insurance code of 1956 is exempt from this act. This includes an entity that owns, is owned by, or is under common ownership with such an entity, and maintains the same cybersecurity procedures as that other entity.     HB 6406, 445.64

Utah adopted a new rule prohibiting firearms, ammunition, dangerous weapons, and explosives (exclusive of law enforcement officers) at offices of the Insurance Department's Fraud Division.     Rule R590-279


GROUP HEALTH

Vermont issued an emergency regulation instituting a licensing requirement for self-insured multiple employer welfare arrangements and association health plans.     Emergency Regulation 2018-02-E s 5

Washington adopted emergency rules regarding requirements for Pathway 2 Association Health Plans.     284-43-9000; 284-43-9010; 284-43-9020


HEALTH INSURANCE / HEALTH RATES

Oregon amended its rules regarding reimbursement rates for out-of-network services provided at in-network health care facilities.     836-053-1600, 836-053-1605, 836-053-1610, 836-053-1615

The Centers for Medicare & Medicaid Services (CMS) issued the proposed annual Notice of Benefit and Payment Parameters for the 2020 benefit year which will affect the Federal Exchange, individual, small group, and large group market health insurance.     CMS Notice dated January 17, 2019a

Vermont issued an emergency regulation regarding rating requirements for self-insured multiple employer welfare arrangements and association health plans.     Emergency Regulation 2018-02-E s 7


HEALTH MAINTENANCE ORGANIZATIONS

Alabama issued a bulletin regarding association health plans for health maintenance organizations.     Bulletin No. 2019-01


LIFE INSURANCE / LIFE CONTRACTS

Maryland issued a bulletin to update and replace Bulletin 18-22 and to clarify requirements of Senate Bill 168, Chapter 143 concerning Underwriting Standards and Procedures for life insurance policies for minors.     Bulletin 18-24


MEDICARE SUPPLEMENT INSURANCE

Kentucky has amended their administrative regulations regarding minimum standards for Medicare supplement insurance policies and certificates.     806 KAR 17:570

Maryland amended regulations outlining the standard Medicare supplement benefit plans for individuals newly eligible for Medicare on or after January 1, 2020.     COMAR 31.10.06.02, .28, .30 and .31


MENTAL HEALTH PARITY

New Hampshire amended its regulation to establish a parity of group coverage for mental health and substance abuse disorders benefits.     2702.04


MISCELLANEOUS

California has adopted new regulations to provide a methodology insurers can use to determine the reimbursement rate of noncontracting health care professionals.     Title 10 s 2238.11

The Louisiana Department of Health has extended an emergency rule amending the provisions governing the reimbursement methodology for public intermediate care facilities for persons with intellectual disabilities. This rule is now effective until 06/09/19.     LAC 50:VII.32915

New Jersey issued a bulletin encouraging insurers and producers to consider the negative impact on many residents as a result of the partial shutdown of the Federal government by relaxing due dates for premium payments, extending grace periods, waiving late fees, etc.     Bulletin No. 19-01

New York issued a circular letter regarding the use of external consumer data and information sources in underwriting for life insurance.     Insurance Circular Letter No. 1 (2019)

Texas amended its regulation relating to the 2019 rates of assessment for maintenance taxes and fees imposed on gross premiums.     28 TAC s 1.414


PRE-EXISTING CONDITIONS

Wisconsin issued an executive order relating to the preservation of insurance protections for consumers with pre-existing conditions.     Executive Order #4


PRE-NEED CONTRACTS

Ohio amended its rule regarding the pre-need funeral contract annual report.  Reports are now due on March 31st every year instead of the previous due date of March 30th.     Rule 4717-10-01


REGULATORY REPORTING REQUIREMENTS

New Mexico issued a bulletin to clarify the reporting requirements for major medical and dental insurance carriers.     Bulletin 2019-001


REINSURANCE

Oregon adopted rules relating to implementation of the Oregon Reinsurance Program.     OAR 836-150-0010, 0020, 0030, 0040, 0050, 0060


REPORTS - ANNUAL / QUARTERLY STATEMENT

Florida amended insurer reporting requirements to improve surveillance of the financial conditions of insurers.     FAC 69O-137.002

Oregon amended its regulation regarding the adoption of 2018 annual and 2019 quarterly statement blanks and instructions for insurers.     836-011-0000


SERFF FILINGS

Massachusetts issued a message via SERFF regarding various changes in filing requirements and updated forms and instructions.  Requirements bearing an edition date of 01/19 are required to be used in all filings by 2/19/19.     SERFF Message dated 1/2/19


STANDARD VALUATION LAW

Oregon amended its regulation regarding specific standards for morbidity for valuation of individual and group health insurance policies.     836-031-0270

Oregon amended its regulation regarding the valuation manual insurers must use for principle-based reserving.     836-031-0605